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CT-based evaluation of volumetric bone density in fragility fractures of the pelvis-a matched case-control analysis.
Osteoporos Int. 2018 02; 29(2):459-465.OI

Abstract

This matched case-control study compared the computed tomography (CT)-based regional bone density of patients with fragility fractures of the sacrum to a control without fracture. Patients with a sacral fracture demonstrated a significantly lower regional bone density of the sacrum, the sacral bone density not being correlated with the BMD by DXA of the spine.

INTRODUCTION

The aim of this study is to compare the computed tomography-based regional bone density measured by Hounsfield units (HUs) in patients with and without fragility fractures of the sacrum.

METHODS

Patients aged ≥ 50 years with a fragility fracture of the sacrum were compared to patients of similar age and gender who had a fall from standing height without fracture (n = 46). A matched case-control analysis was conducted by retrospective chart review and assessment of areal bone mineral density by lumbar DXA and by volumetric regional HU measurements in uncalibrated CT scans of the sacrum.

RESULTS

Patients with a sacral fracture (age 74 ± 11 years) showed a lower bone density in the body of S1 (HU 85 ± 22) when compared to the matched control group without fracture (age 73 ± 10 years, HU 125 ± 37, p < 0.001). The CT-based bone density of S1 did not correlate with the DXA values of the lumbar spine (r = 0.223, p = 0.136), and lumbar spine T-scores did not differ between the groups (- 2.0 ± 1.3 vs. - 1.9 ± 1.2, p = 0.786). All measurements are based on uncalibrated scans, and absolute HU values are restricted to scans made on Siemens SOMATOM Force or SOMATOM Edge scanners.

CONCLUSIONS

Patients with fragility fractures of the sacrum demonstrated a lower regional volumetric bone density of the sacrum when compared to a cohort without a fracture. Local sacral volumetric bone density as measured by CT seems to be independent from the areal BMD as measured by DXA of the lumbar spine.

LEVEL OF EVIDENCE

level III.

Authors+Show Affiliations

Division of Trauma Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland.Division of Trauma Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.Division of Trauma Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.Division of Trauma Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. georg.osterhoff@usz.ch.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29134241

Citation

Schönenberg, D, et al. "CT-based Evaluation of Volumetric Bone Density in Fragility Fractures of the Pelvis-a Matched Case-control Analysis." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 29, no. 2, 2018, pp. 459-465.
Schönenberg D, Guggenberger R, Frey D, et al. CT-based evaluation of volumetric bone density in fragility fractures of the pelvis-a matched case-control analysis. Osteoporos Int. 2018;29(2):459-465.
Schönenberg, D., Guggenberger, R., Frey, D., Pape, H. C., Simmen, H. P., & Osterhoff, G. (2018). CT-based evaluation of volumetric bone density in fragility fractures of the pelvis-a matched case-control analysis. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 29(2), 459-465. https://doi.org/10.1007/s00198-017-4307-6
Schönenberg D, et al. CT-based Evaluation of Volumetric Bone Density in Fragility Fractures of the Pelvis-a Matched Case-control Analysis. Osteoporos Int. 2018;29(2):459-465. PubMed PMID: 29134241.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - CT-based evaluation of volumetric bone density in fragility fractures of the pelvis-a matched case-control analysis. AU - Schönenberg,D, AU - Guggenberger,R, AU - Frey,D, AU - Pape,H-C, AU - Simmen,H-P, AU - Osterhoff,G, Y1 - 2017/11/13/ PY - 2017/07/27/received PY - 2017/11/06/accepted PY - 2017/11/15/pubmed PY - 2019/2/5/medline PY - 2017/11/15/entrez KW - Computed tomography KW - Dual-energy X-ray absorptiometry KW - Hounsfield units KW - Osteoporosis KW - Pelvic fracture KW - Sacral fracture SP - 459 EP - 465 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 29 IS - 2 N2 - : This matched case-control study compared the computed tomography (CT)-based regional bone density of patients with fragility fractures of the sacrum to a control without fracture. Patients with a sacral fracture demonstrated a significantly lower regional bone density of the sacrum, the sacral bone density not being correlated with the BMD by DXA of the spine. INTRODUCTION: The aim of this study is to compare the computed tomography-based regional bone density measured by Hounsfield units (HUs) in patients with and without fragility fractures of the sacrum. METHODS: Patients aged ≥ 50 years with a fragility fracture of the sacrum were compared to patients of similar age and gender who had a fall from standing height without fracture (n = 46). A matched case-control analysis was conducted by retrospective chart review and assessment of areal bone mineral density by lumbar DXA and by volumetric regional HU measurements in uncalibrated CT scans of the sacrum. RESULTS: Patients with a sacral fracture (age 74 ± 11 years) showed a lower bone density in the body of S1 (HU 85 ± 22) when compared to the matched control group without fracture (age 73 ± 10 years, HU 125 ± 37, p < 0.001). The CT-based bone density of S1 did not correlate with the DXA values of the lumbar spine (r = 0.223, p = 0.136), and lumbar spine T-scores did not differ between the groups (- 2.0 ± 1.3 vs. - 1.9 ± 1.2, p = 0.786). All measurements are based on uncalibrated scans, and absolute HU values are restricted to scans made on Siemens SOMATOM Force or SOMATOM Edge scanners. CONCLUSIONS: Patients with fragility fractures of the sacrum demonstrated a lower regional volumetric bone density of the sacrum when compared to a cohort without a fracture. Local sacral volumetric bone density as measured by CT seems to be independent from the areal BMD as measured by DXA of the lumbar spine. LEVEL OF EVIDENCE: level III. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/29134241/CT_based_evaluation_of_volumetric_bone_density_in_fragility_fractures_of_the_pelvis_a_matched_case_control_analysis_ L2 - https://doi.org/10.1007/s00198-017-4307-6 DB - PRIME DP - Unbound Medicine ER -